Nested EPA: Ostomy Takedown

Nested EPA: Ostomy Takedown

Dissection and mobilization of ostomy by correctly identifying the distinction between subcutaneous tissue, scar tissue, and mesentery. Able to perform mobilization without injury to bowel or mesentery. Excludes the anastomosis.

Evaluatee Name (Last, First)*

Enter resident starting with last name. Once a form has been submitted, the resident will receive a copy of the evaluation.

Select or enter value

Evaluator Name (Last, First)*

Type your name and press "enter" if you do not see your name on the dropdown list

Select or enter value

Date of Assessment*

Rotation*

Select or enter value

Anatomy*

Names but requires prompting to identify abdominal wall anatomy, edge of the bowel, and mesentery

Demonstrates basic understanding of anatomy including abdominal wall anatomy, edge of the bowel, and mesentery

Demonstrates understanding of anatomy in straightforward cases, but cannot adapt to abnormal anatomy (parastomal hernia, extensive scarring, or obesity)

Understands anatomy. Independently identifies abnormal anatomy and pivots operative plan as needed to accommodate for unexpected findings. Walks junior residents through ostomy takedown in a straightforward case.

Surgical Technique*

Handles instruments safely but tentatively. Follows intraop directions. Displays coordinated hand movements for simple maneuvers under direct instruction, but is inefficient with basic skills.

Displays some coordination of instruments, but tissue handling is inconsistent with both hands. Requires some prompting to stay in correct dissection plane and avoid injury to nearby structures.

Consistently displays careful tissue handling. Stays in correct dissection plane. Avoids injury to nearby structures. May require assistance in complex cases or re-operative fields.

Careful tissue handling and avoids injury in both straightforward and complex dissections.

Steps of Procedure*

Requires prompting to articulate steps of operation

Articulates basic steps but requires active direction to move case forward

Performs in straightforward cases but requires guidance in complex cases (parastomal hernia, extensive scarring, or obesity)

Devises/implements plan when deviation from the initial operative plan is required

Dealing with Potential Error / Complications*

Identifies basic complications (oozing, bleeding from bowel edges, or serosal injuries)

Independently manages basic complications

Independently manages basic complications. Identifies severe complications (devascularization of bowel, contamination, injury to underlying bowel, injury to abdominal wall, or dissection into pre-peritoneal space)

Takes appropriate precautions to minimize common complications (ex: dissecting right on bowel). Implements early management plans for severe complications.

Overall Performance*

Limited Participation - Demonstrates understanding of information and has very basic skills

Direct Supervision - Demonstrates understanding of the steps of the operation but requires direction through principles and does not know the nuances of a basic case

Indirect Supervision - Can do a basic operation but will not recognize abnormalities and does not understand the nuances of an advanced case

Practice Ready - Can manage more complex patient presentations and operations and take care of most cases

Comment*

Please add a comment on why you selected the answer above. Specifically note what steps the resident can take to achieve the next level of autonomy.

Send me a copy of my responses

Privacy Notice|Report Abuse